Neral tube defects are the most common congenital malformations of the CNS. There is a failure of closure of the neural tube during the 1 st trimestr. The closure involves the neural plate, meninges, vertebral arches, soft tissues and epidermis. Spina bifida, rachischisis and as for the brain anencephaly and encephalocele are classified with the neural tube defects. Neural tube defects can be recognised prenatally by detection of high levels of alphafetoprotein (AFP)in the maternal blood. This test is routinely done at 16 – 18 weeks (triple test). Elevated AFP is seen in open defects uncovered by skin. Prenatal diagnosis is also done by ultrasound examination.